Elevated basal serum tryptase and hymenoptera venom allergy: relation to severity of sting reactions and to safety and efficacy of venom immunotherapy

• Published in: Clinical and experimental allergy 2003-09, Vol.33 (9), p.1216-1220
• Main Authors: Haeberli, G., Brönnimann, M., Hunziker, T., Müller, U.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Allergic diseases; Anaphylaxis - enzymology; Anaphylaxis - immunology; Animals; Arthropod Venoms - immunology; Bee Venoms - immunology; Biological and medical sciences; Child; Child, Preschool; Female; Humans; Hymenoptera - immunology; hymenoptera venom allergy; Immunopathology; immunotherapy; Immunotherapy - adverse effects; Immunotherapy - methods; Insect Bites and Stings - enzymology; Insect Bites and Stings - immunology; Male; mastocytosis; Mastocytosis, Cutaneous - immunology; Medical sciences; Middle Aged; Serine Endopeptidases - blood; Skin allergic diseases. Stinging insect allergies; sting challenge; tryptase; Tryptases; Wasp Venoms - immunology
• ISSN: 0954-7894; 1365-2222
• DOI: 10.1046/j.1365-2222.2003.01755.x

Summary Background Mastocytosis and/or elevated basal serum tryptase may be associated with severe anaphylaxis. Objective To analyse Hymenoptera venom‐allergic patients with regard to basal tryptase in relation to the severity of sting reactions and the safety and efficacy of venom immunotherapy. Methods Basal serum tryptase was measured in 259 Hymenoptera venom‐allergic patients (158 honey bee, 101 Vespula). In 161 of these (104 honey bee, 57 Vespula), a sting challenge was performed during venom immunotherapy. Results Nineteen of the 259 patients had an elevated basal serum tryptase. Evidence of cutaneous mastocytosis as documented by skin biopsy was present in 3 of 16 patients (18.8%). There was a clear correlation of basal serum tryptase to the grade of the initial allergic reaction (P